Seeking Care for Low Back Pain in the General Population

Abstract

STUDY DESIGN: A 2-year follow-up study was conducted to investigate new patients who sought care for low back pain from all the caregivers in a specific region with a population of approximately 17,000 men and women ages 20 to 59 years. OBJECTIVES: To describe care-seeking behavior for low back pain in a general population; to characterize pain, disability, and sick leave among the patients; and to study predictors of recovery. An additional aim was to find a simple way of classifying low back pain in epidemiologic studies. SUMMARY OF BACKGROUND DATA: Low back pain is very common, but its natural history in a general population and predictors of recovery are not fully known. METHODS: All the patients went through a clinical examination, and data on personal, medical, and occupational history were collected. Follow-up assessments were made during a 2-year period. RESULTS: Whereas 50% of the patients went to physicians and physiotherapists for treatment, 50% went to other caregivers. Some improvements in pain and disability were reported after 3 months, but not many after that. Approximately 70% of the care seekers had not been on sick leave during the follow-up period. Care seeking during the follow-up period was not associated with reduced pain and disability. No predictive factors for recovery were found. A simple pain drawing made by the patient gave information about pain distribution similar to that found by clinical examination. CONCLUSIONS: In a general working population in Sweden ages 20-59 years, approximately 5% sought care because of a new low back pain episode during a 3-year period. Few of the care seekers became pain-free during the follow-up period. This study strengthens the hypothesis that low back pain often becomes chronic even when sick leave is rare.